HomeMy WebLinkAbout0102804-HVAC (furnace)(~ CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1191 BLOSSOM CT Owner MARLYN J SUPIANO
Contractor STEINBRUNER HEATING & COOLING Category 500 - Residential-Heating & Ventilating
Fuel ~J Gas J ~J Oil b~ Electric ~J Solar
System ~J New ~ ~J Replace ~ ~J Other
~J Forced Air I ~J Radiant L~ Steam ~J A/C
~J Electric I ~J Hot Water b~ suppl. ~J Con. Burner
Chimney Type I~ Chimney A ~ Chimney B O Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value 40m btu
No
Create Date
Plan
~J Solid
Vent
102804
07/14/2003
Use/Nature CONDO/Replace furnace and chimney liner. *EIV form from Seckar Electric.
of Work
Fees: Valuation
Issued By:
$1,800.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided
$32.00
Date 07/14/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 600 OREGON STREET OSHKOSH WI 54902 -0
Telephone Number
(920) 426-1830
07/10/2~03 21:10 19204261098 STEINBRUNER HEATING: PAGE 81
City of Oshkosh
Division of Inspection Scrv
P.O. Box 1 ! 30
OShkosh, W1 549034 130
l~one (920) 236-:5050
Fa~ (920) 236-5084
· Application(s) and fe
Oshkosh WI 54903-
normal permit fee, v~
OR
!~f vcu are a contracro~
~ ¥O~t want this oro~(~
~OB ADDRESS..~i.~J.
"CONTRACTOR
CllECK ~1 ALL APPLI
CATEGORY
VISingle Family
~oreed Air VIRadiant £
~J CHIMNEY BEING !
N~te: All cbi.,n.~eys shall be
' C~IMNEY TYPE
lglKAT LOSS
D~:SCRIFI'ION OF Al
VALUE (Including labor
ELECTRICAl.. CONT~
HVAC PERMIT APPLICATION
All information after bold categories must b~ pwvide(
Incomplete applications will not be processed.
.'(s) can be brought 4o Cit~ Hall, Room 205 or mailed to Ins]
128. Commencing work without permit(s) will result in
ach ever is greater,
oarticio~i, ng in the Permit fee Accoupt System and ~
DA
)uplcx nMulti-Family ~lRental nComm
UIElectnc DSolid SYSTEM E]New
t"lSolar FIOth~
ISteam EIA/C E]Vent l"lElecwic r'lHot Water ~Suppl. E]C(
.INED r'lNo ERYes . LINER SIZE
si2ed per the BTU'~ being vented.
]Chimney A E]C....h~ey B
]As Approved [~Existmg
]As Per Plan I-IVariable
,~ (' & MANUF
~irect Vent
I-INot Applicable
nOther Value
L WORK BEING DONE
C fHKOSH
.'etlon Services, PO Box 1128,
; being doubled or $100.00 plus the
~ve adeauate funds, check her.q
rcial ~Industrial
k~eplace
Burner
~CTURER
~ , 07/t0/2003 21:i0
(We)
(At
have been cc
at thc follow
Thc nature
The value of
] hereby verif
the reconnecti
requirements.
(Signa~re c
19204261000
STEINBRUNER HEATING:
PAGE 02
Electric Installation Verificati
(Elecl~cal Contractor N~e)
d~s) (City)
atracted to perfo~ elee~c installation work for ~
(Address where work will be p~
the work consists of: (Check One or Describe the Natt
~econnection or new circuit for replacement Heating P1
~econnection or new circuit for rcplacemcnt Electric W
water heater,
~ecormection of the Service Entrance Cable, Meter Bo:~
and lighting fixtures due to siding / soffit installatio~
Entrance Cables will require a separme permit.
[cconnection or new circuit for the replacement ofothc
appliances / fixtures.
Yew circuit for the addition of A/C to an individual dw~
individual systems in a duplex or condominium), im
elecirical omlets,
)ther
this work will be performed by an employee of this c¢
on / installation will be done in compliance with manal
fCompany Officer)
(Print Name of Officer)
)n
(State) (Zip Code)
e of party contracted to)
fformed)
re of Work)
mt and/or A/C Condenser.
~ter Heater or power vented
alterations to receptacles
Note: New Service
permanently wired
~ling unit (house or
luding required s01'vice
mpany and further verify
~cturer and Electric code
(Date)